Minnesota Poll: Party split felt over MNsure, health reform

Minnesotans remain divided along party lines over the federal health law and whether the state should keep its troubled online insurance exchange, MNsure.

Half of Minnesotans think their health care situation will be the same or better under the new law, according to the latest Star Tribune Minnesota Poll. About one in five said their situation will improve.

But 46 percent of those polled believe their health situation will be worse under the law. Nearly nine in 10 Republicans said they expect their situation to get worse, while 84 percent of Democrats expect it to be the same or better.

Minnesota's views track national trends that show partisan rancor remains closely intertwined with the Affordable Care Act (ACA), whose most sweeping provisions went into place this year.

State residents also split along party lines on whether to keep the glitch-plagued MNsure exchange or start over and build a new one. Four in 10 poll respondents said keep it, while 40 percent were in favor of starting again.

David Meyer, 50, of Rochester, was one of the Republicans who predicted his family would be worse off under the new law and said the state should ditch MNsure. He gets coverage through his wife's employer and believes the ACA is causing premiums to rise.

"Health care is something that we definitely need to focus on and improve," Meyer said. "I'm just not sure this was ultimately the right answer, but maybe it gets us closer to where we need to be."

The divisions over the federal health care law reflect some of the challenges state officials face as they try to get Minnesotans enrolled in coverage by the end of open enrollment on March 31.

"We've been working really hard to improve the customer experience," said MNsure interim CEO Scott Leitz, who acknowledges that the site is "improved but not perfect."

Leitz said the poll results weren't a surprise. A new marketing campaign launched last week aims to break through the rash of bad publicity about technical problems with the website and to encourage uninsured Minnesotans to shop on MNsure. A key goal of the exchange is to help the nearly 500,000 Minnesotans who are uninsured buy coverage.

So far, about 101,000 people have used the website to buy insurance coverage, and efforts to improve the site and add staff to the call center are ongoing.

Republican lawmakers already are promising to use MNsure's tumult as a campaign issue, emphasizing that it is a failure of big government. As DFL Gov. Mark Dayton ramps up his effort to win a second term, one Twin Cities group has passed out buttons with Dayton's face and the label, "Governor Obama­care."

The Star Tribune poll found that Minnesotans are evenly split (40 percent to 40 percent) about whether to get rid of the MNsure system, while 20 percent said they aren't sure what should be done.

For MNsure officials, the focus is on getting the existing site working for an expected rush of traffic in March, but Leitz and the MNsure board of directors will shortly thereafter need to determine the long-term fate of the current system. MNsure's leaders have said all options are on the table, but scrapping and starting over is "a more drastic option," and not the starting point of the evaluation, Leitz said.

The upheaval caused by the federal health law is to be expected, analysts say. A report last week from the Urban Institute said that the effect is much less than what it would have been had the country moved to a single-payer system. That's because most Americans still get their insurance through their workplace, and the ACA has no effect on businesses with more than 100 employees.

The ACA's reforms are largely focused on the individual and small-group insurance markets.

"No one likes disruption," said Judy Feder, the report's author and a fellow at the Urban Institute's Health Policy Center. "But, compared to alternatives, the ACA's disruption is modest in scope, cushioned by subsidies, and, over time, will benefit all participants."

"People I know who have tried to use [MNsure] have been extremely disappointed," she said. "But big picture, we have to get people covered, and it has to not be connected to employment."

Olsen, a DFLer, said coverage is still "extremely expensive" for her family but that the health law is a step in the right direction.

"I feel like the health care system is in shambles, and no one's willing to try to make the difficult decisions to change it," she said. "People need to be willing to push through the mud to get old people and young people with health coverage so the system can change."